order form for taxi rides

name of orderer:     e-mail:  

one-way or journey there and back (please select):
(ordering an one-way tour please fill either journey there or journey back)

journey there

date:     pick up time:
  a.m. / p.m.
from city:     street:   number:
name:     number of persons:   cell phone:
to city:     street:   number:

journey back

date: pick up time:  
a.m. / p.m.  
from city:   street:   number:   
name: number of persons:  
to city: street:   number:  

payment:     EC, credit card (from 25,-€) (what kind please write by "notes")   notes:  
    invoice (only for companies with headquarters in
  (for example: golfbags,
child car seat, 
 if yes,
    cash     what kind of?)  

  name of company :  
  name of responsible :  
  street :  
  postcode, city / country :  

  By placing the order you accept our disclaimer.